Programme

In West Hampshire we recognised that there was a burden of undiagnosed atrial fibrillation within our community, which was resulting in a significant number of preventable strokes. This could be addressed by the prescription of anticoagulation therapy in those at increased risk.

The objective of the AF-stroke prevention programme was to improve detection of undiagnosed atrial fibrillation in West Hampshire via opportunistic screening utilising the NICE endorsed WatchBP monitor, aiming – with appropriate anticoagulation therapy – to reduce the incidence of strokes.

There were four aspects to the AF-stroke prevention programme including proactive leadership, opportunistic screening, optimising anticoagulation and evaluation/audit.

This presentation will highlight both the challenges and achievements of the programme.

Although premature CVD mortality has fallen substantially in the last 30 years, CVD remains a major burden for the NHS: it is the second largest cause of death under 75, it costs the NHS £7bn a year, and is a major contributor to health inequalities

CVD is highly preventable through population and behaviour change interventions to support lifestyle change, but also through secondary prevention in high risk conditions like high blood pressure and atrial fibrillation. However, although treatment of these conditions is highly effective at preventing strokes and heart attacks, late diagnosis and undertreatment is very common – around half of all patients with these conditions do not receive the right preventive treatment or are not treated to target.

The NHS England’s Next Steps on the 5 Year Forward View has highlighted CVD prevention, and particularly secondary prevention, as a priority for the NHS. But how can we deliver this when there is no spare capacity in general practice? The answer is by doing things differently. In our session we will show how we have done things differently in two CCGs and improved outcomes for our patients while minimising workload in general practice.